These days many cesarean sections heal up well with a scar that is barely visible. However, the surgery leaves many other effects including numbness, discomfort and disconnection from the lower abdominals. The scar can often hold strong emotions as well. All births are a time of extreme vulnerability and deep transformation. Women’s birth scars are the symbols of their own rebirthing.

In my private practice, I do a lot of birth scar massage. Through mindful attention and touch, I encourage scar tissue to break up so that the underlying tissues are free to move as they are meant to and receive healthy blood flow. Many women have not wanted to look at or touch their scars because of how much this brings to the surface for them. When we massage these areas, we process the emotions held there by giving voice to the feelings. Through working on both the physical and emotional layers, the scar tissue begins to melt.

Aside from the more immediate physical and emotional impact of surgery, scar tissue can sometimes have far reaching and long term effects.

A simple and highly effective at home treatment for scars is castor oil packs. Castor oil is derived from the castor seed and has been used as a healing remedy for centuries. Castor oil helps to decrease inflammation, pull out toxins in tissues and dissolve scar tissue. (By the way, you can use these treatments for any type of surgery or scar tissue in the body).

Here’s how to do it:

Supplies

High quality organic castor oil.

Organic cotton flannel (usually sold right next to castor oil at your local holistic pharmacy or find here).

A hot water bottle or a heating pad.

Layer of plastic (saran wrap or cut up a plastic bag or trash bag). I use the old packages from my flannel.

Preparation

Cut two layers of flannel to cover your scar and the surrounding areas. Can be about the size of your heating pad or hot water bottle.

Cut a piece of plastic that is a little larger than your flannel pieces.

Stack the flannel one on top of the other. Place enough castor oil on the top piece of flannel only to almost saturate but not soak the material. Usually a couple of tablespoons. (Because castor oil is quite thick and sticky I end up pouring lines of it on and then folding the fabric in various ways to spread it out). The second piece of flannel is just there to absorb any extra castor oil.

Process

***Note: Like anything, there is a small chance that you could be allergic to castor oil. Place a small amount on your skin to test before doing a full treatment.

Place the castor oil side of the flannel layers over your scar. Place the piece of plastic over the flannel (this is to protect your heat source).

Place your hot water bottle or heating pad on top of the plastic.

You may want to place a towel underneath you in the event that the castor oil drips (although it shouldn’t be this soaked). When I use a hot water bottle I also put a towel or blanket on top to keep the heat in.

Relax and enjoy this treatment for 20-30 minutes. Use it as a time to meditate on nice, deep belly breathes.

Afterward you can spend a little time gently massaging the area.

Wash the castor oil off with soap and water.

For perineal or internal vaginal scar tissue:

You can thoroughly soak an organic cotton tampon in castor oil and place this inside for 20-30 minutes.

What to Expect

Your belly will be really soft after. Some women who are wanting to strengthen their abs postpartum don’t like this softening. It’s a temporary result of the treatment and will go back to normal within a couple of hours. Softening is a good sign because that is what you want to happen with the underlying scar tissue. Also, remember that our bellies are supposed to be somewhat soft, they’re holding all of our squishy internal organs.

Intestinal bloating or discomfort. This can be a sign that you have an imbalance in your gut flora. The castor oil treatment will help this. Castor oil treatments can also induce bowel movements. Back off the treatments a bit if the intestinal side effects are bothersome.

Following a castor oil treatment your scar may be red or a little weepy—meaning it might be releasing a little fluid. This is normal and a good sign that things are changing.

FAQs

Can I re-use the flannel?

Some people say absolutely never and some say you can use it a few times. It’s important to consider that this treatment is pulling out toxins so these will also be soaking into the flannel. I save and re-use the second layer that hasn’t been on my skin.

How often do I need to do these treatments?

The effects of castor oil are cumulative, meaning the more regular you are, the more effective it will be. I like people to start out slowly with about three treatments per week and build up to daily treatments for 30 days. (Depending on your level of sensitivity daily treatments might be too much, adjust accordingly).

How can I possibly find the time do this every day?

I work with tons of moms and know how precious time is. The most important thing is to simply do the best you can. It’s better to do a treatment once a week than never. Also, know that once you get your routine down, the preparation will be much faster.

My advice is to approach this as a loving self care ritual that feeds and nurtures you. Light a candle, put on your favorite essential oils, play some relaxing music and soak in the time for yourself. It will serve both you and your family.

Diastasis recti is a common condition seen in postpartum women where connective tissue in the abdominal muscles, the linea alba, thins and spreads out causing the abdominal muscles to separate. This separation in the rectus abdominis can cause a bulging tummy, umbilical hernia, back pain, postural problems and pelvic floor weakness. Diastasis recti can happen to anyone, men, women or children however it is very prevalent after the increased abdominal pressure of pregnancy.

How to Check Yourself for Diastasis

Lay down on your back with your feet on the floor hip distance apart and your knees bent. Check for the following three things:

1. SpacePlace the fingers of one hand at the center of your abdominal muscles starting just below the solar plexus. Bring the other hand to the back of your head. As you lift your head up from the ground and engage your abdominals, you may be able to feel the edges of your rectus abdominis on either side. Notice the size of the space in between those muscles when they initially fire--just as you begin to lift your head. The muscles will come closer together as you fully engage so finding the starting point is important.

The space between the rectus can be anything between one finger and up to four fingers or more wide. It can be helpful to move the fingers side to side to find the edges of the rectus muscles. Repeat this check at several points from the solar plexus down to your pubic bone. Typically there is the greatest amount of separation around the navel.

2. DensityCheck the degree of softness in your tissue in this space between the rectus as you engage your muscles. Do your fingers sink down far into your belly? Soft tissue means you need to develop strength and do more to protect your abdomen.

3. BulgingDoes your stomach push out when you engage it? This can look like bulging or tenting.

Another thing to pay attention to here is if you have a habit of bearing down when you try to fire the abdominal muscles. This is the feeling of pushing like during labor or a bowel movement. It will cause the abdominals to bulge and also put too much pressure on the pelvic floor causing bladder issues. If you bare down or bulge out you need to retrain your core muscles to pull everything in and provide support.

In my experience working with dozens of women that have diastasis, there are many factors that determine whether or not a woman has a true diastasis and whether or not the separation is something that requires special focus to repair. I take into account a combination of the above elements. If you think that you might have diastasis, it can be helpful to get a second opinion from someone that specializes in this condition.

As a yoga teacher, doula and somatic sexologist I help women process their births and the subsequent changes in their bodies and relationships. I often say that I help women put their bodies back together after birth. My area of specialty and great passion is the core which includes the muscles of the abdominals, low back, pelvic floor and diaphragm. Most women come to me initially for weakness and the change of appearance in their abdominals due to diastasis recti. They want to lose their mummy tummy! In our first meeting it quickly unfolds that diastasis is affecting numerous areas of their lives including, and often especially, intimacy!

Diastasis recti is a common condition seen in postpartum women where connective tissue in the abdominal muscles, the linea alba, thins and spreads out causing the abdominal muscles to separate. This separation in the rectus abdominis can cause a bulging tummy, umbilical hernia, back pain, postural problems and pelvic floor weakness. Women who have diastasis recti describe an overall feeling of disconnection from their center.

Our core, is our very center--as the name implies--and when the core is out of alignment or weak it can throw us off in a multitude of ways. As a yoga teacher and somatic sexologist I look at the physical, emotional and energetic components that come into play for women who have diastasis. Each of these different layers can interfere with sexuality and intimacy.

New parenthood in and of itself is an adjustment for couples. The lack of sleep, the newness of the bond they find with their baby, the demands of taking care of that baby 24/7, financial stress and hormonal changes are all well known ingredients in extinguishing the romantic fire for both men and women. Here, I would like to explore specifically how diastasis might add strain to your love life through each layer; physical, emotional and energetic.

Physical - Women who have diastasis are often in pain or discomfort. Their backs and shoulders ache, they may have pelvic pain. There can be a feeling of discomfort in the abdomen itself. It doesn’t matter how you slice it, pain is not sexy.

Women with diastasis also have a feeling that their bodies don’t work the same way and that they don’t have the same amount of strength and feeling of togetherness, or full body integrity that they were previously used to. Their bellies can be bulging and bloated. A common phrase I hear is, “This doesn’t feel like my body.”

Lastly in the physical realm, diastasis can contribute to pelvic floor weakness which can lead to incontinence and organ prolapse (when organs like the bladder or uterus fall out of place and start to hang into the vagina).

Emotional - We know that negative body image is an issue that almost universally impacts every American woman at some point in her life. The postpartum period is certainly no different and can be a real challenge for women’s self esteem. In fact, muscles carry, or hold, emotions and certain muscles are associated with specific emotions. The emotion most connected with the rectus abdominis (the abdominal muscles that separate with a diastasis) is self esteem.

Women feel so much pressure to obtain a certain, unobtainable body image that pervades all areas of our culture where real pregnant and postpartum bodies are not recognized. When women are feeling ashamed of their bodies because of how they look or feel, they don’t want them to be seen and they often don’t feel like they deserve to be loved, honored and cherished with their imperfections.

Energetic - Just like emotions, the body also has energetic qualities that have been part of ancient eastern philosophy for centuries and are now being recognized by modern science. In yogic philosophy the sexual center is in the core. The area below the navel that holds our womb and organs of reproduction also holds the energy of creativity, wealth, fertility, sensuality and sexuality.

When a woman is not feeling physically or emotionally connected to her core, she is unplugged from her libido. She is missing out on the magic of her desire, passion and sensuality.

The good news is that there are specific exercises to heal diastasis and there is also a process of self acceptance and self love that can heal the emotional wounds. Through reconnecting to the core physically, emotionally and energetically women can start to feel full again and get their mojo back.

As a woman who has never given birth, I am humbled by the stories that so many women have shared with me about their births and postpartum recovery experiences. I feel blessed to hold space for the processing of these great rites of passage and to support women on this journey.

Your sore shoulder, constipation, sexual pain, infertility--all of these things can be a result of scar tissue in your body. Why hasn’t anyone told you about this possibility before? Mainstream medicine rarely looks at scar tissue because they don’t yet use effective ways for diagnosing and treating scar tissue.

Working with scar tissue, particularly in the abdomen and pelvis, is part of my training as a sexological bodyworker. My teacher, Ellen Heed, describes scar tissue as one of the four obstacles to radiant health as important as imbalances in posture, emotions and nutrition. The good news is that scar tissue can be easy to find if you know what you’re looking for and there are simple treatments.

Where Does Scar Tissue Come From?We are all familiar with scars that form when our skin has been cut. Sometimes dark purple, sometimes white, scars knit our tissues back together. Scar tissue can also form under the surface where we cannot see it. In addition to cuts and surgeries we can develop scar tissue from infection, injuries, illness, childbirth and inflammation in the body. Even emotions held in our tissues can lead to scar tissue.

What is Scar Tissue?When an area is injured, cells called fibroblasts come in to protect and knit the area back together. Fibroblasts are rich in collagen which makes for a denser connective tissue. These fibroblasts are also highly disorganized--they do not form in nice, neat patterns that match the rest of our tissues. This combination of density and disorganization is responsible for the crunchy, bumpy and inflexible feelings we often associate with scars.

What are Adhesions?All of the muscles and organs in your body are covered by a layer of fascia. Fascia is like a thin sweater that covers, penetrates and separates muscles and organs. Scar tissue likes to travel along fascia, its disorganization can cause it to continually form and travel from your right hip all the way up to your left shoulder along the knit highway of fascia.

If you have a c-section scar and suddenly one day have sexual pain, this may be due to scar tissue traveling from you abdomen down into your pelvis and forming adhesions. Adhesions occur when scar tissue glues the fascia of tissues or organs together. So in the case of sexual pain, you might have two pelvic muscles glued together causing discomfort. In the case of infertility, adhesions can glue the walls of the fallopian tubes together so there is not ample space for an egg to pass through. For constipation your intestines might be glued to your abdominal wall.

What Do Scar Tissue and Adhesions Feel Like?Some scar tissue and adhesions are easy to feel and others it may take some skill to identify. If you have scar tissue in your own body it can manifest as tightness and soreness in joints, like a stiff shoulder or a tight hip. You will likely feel a limited range of motion when adhesions are present. Scar tissue particularly around incisions can feel numb, like pins and needles or you may experience a pulling or stretching sensation.

When palpating for scar tissue look for areas under your fingers that feel like wires, crunchy or hard little pebbles. When these areas are really pressed into it can feel everything from numb or dull to sharp knife like pain.

What You Can DoHere are a few ways you can intervene to prevent scar tissue from doing its thing and traveling around your body.

Gentle Stretching - This works particularly well when you’re body is nice and warm perhaps after a walk or cardio exercise. Stretch into those areas of sticky spots just to the edge of discomfort.

Castor Oil Packs - Castor oil comes from the castor seed and has been used as a healing remedy for centuries. In short, castor oil reduces inflammation and it helps to melt scar tissue and draw toxins out of the body. You can find supplies for castor oil packs, oil and flannel, here or at your local holistic pharmacy. Be sure to use high quality organic castor oil to prevent putting more chemicals into your body.

Bodywork - Some bodywork practitioners are trained to help dissolve scar tissue andthe assistance of someone else’s touch can be quite effective. In sexological bodywork, we use castor oil for our scar massage. Sexological bodyworkers also have the training to do internal pelvic work. Other modalities that work with scar tissue are myofascial release and visceral manipulation. Some physical therapists and occupational therapists also are skilled at working with scar tissue and may include internal work in their practice.